Developmental Dyspraxia (Clumsy Child Syndrome)

Developmental Dyspraxia (also known as Developmental Coordination Disorder or the Clumsy Child Syndrome) is a disorder of the processes involved in the planning of movement to achieve a predetermined idea or purpose, which may affect the acquisition of new skills and the execution of those already learned. It can be seen when a child has in mind what he/ she would like to do but has difficulty motor planning and executing the idea making the child appear clumsy or uncoordinated. Dyspraxia may affect one, many, or all areas of development such as physical, intellectual, emotional, social, language, and sensory, and may impair the normal process of learning. Developmental Dyspraxia has a higher incidence in children born pre-term and males versus females.

The first few years of a child’s life are vital for healthy development of movement, coordination, and balance needed to perform skills as he/she continues to grow and mature into an adult. A parent values this time as children reach each milestone. Watching a child begin to kick their legs, reach for objects, and learn how to stabilize their neck and hold their head upright are just the start of an intricate process in their brain. This process begins the formation of many neural pathways of movement that within the next few months become refined and lead to more advanced movement patterns. These movement patterns then lead to more mature coordination and balance allowing a growing child keep up with his/her peers. The physical activities performed are many—running, skipping, kicking a ball, jumping, catching and throwing, riding a bicycle, and the list goes on and on as the child grows through adolescence into adulthood.

Children who are born with a developmental disability due to a medical diagnosis will most likely have a ‘glitch’ in this process of forming the necessary neural connections that aid in attaining needed coordination and balance for the physical demands of childhood. These incidents are identified from a very early age and can be addressed at that time. There are situations when a child is born pre-term or full-term and begins to develop without any marked difficulties but as they continue to reach milestones, the acquisition of new skills becomes challenging in comparison to other children the same age. Minimal challenges or difficulties are common but when those challenges continue and become consistent with other attempts at attaining new skills, it may lead to difficulty with attainment of more advanced balance and coordination skills as the child continues to grow.

Infants and toddlers with dyspraxia have difficulty with motor coordination which could be manifest in milestone delays such as with crawling, standing, and walking. You may notice difficulty as the child makes various attempts in attaining a motor skill. They may appear slightly low tone and have increased frustration with play skills. Gross motor skills and language go hand in hand; if there is difficulty with attainment of gross motor skills, the child may also demonstrate delayed language development and/or difficulty with feeding. School age children with dyspraxia may appear no different from their peers but may have difficulty performing age appropriate gross motor skills such as kicking or catching a ball even after repeated attempts to refine the skill. Skipping and running also become difficult for a child. They may trip more frequently and at times without an obstacle. Falling becomes a regular occurrence compared to their peers. Your child may demonstrate frustration or disappointment with attempts at riding a bicycle and have difficulty coordinating his/her movements to master the skill. Your child’s education may also be impacted. He/she may have difficulty learning to hold a pencil or crayon and have substandard handwriting. This may make it difficult for your child to complete necessary assignments. These difficulties often lead to a disturbance in academic performance and/ or activities of daily living and could lead to increased frustration and stress on the child. It is very common to see many of these signs in children throughout their childhood but a marked difficult with repeated attempts that span through the months may be a cause for concern. What are some signs that will help you determine if you should be concerned? If your child has difficulty with any of the following activities, it would be wise to contact your healthcare provider or a physical, occupational, or speech therapist. Does your child have difficulty with any of the following within the expected age?

• Rolling • Reaching or grasping objects • Crawling on hands and knees • Standing or walking • Hopping on one foot • Jumping with both feet together • Skipping • Kicking or catching a ball • Riding a bicycle with or without training wheels • Cutting or pasting • Learning to hold a pencil or crayon • Handwriting

A child with dyspraxia may also demonstrate any of the following

• Have learning problems or difficulty at school • Consistently prop his head in his hand while reading or writing at a desk • Have poor social skills • Prefer the company of adults • Prefer playing with younger children • May express or demonstrate feelings of failure or frustration • May be withdrawn with limited participation in physical activities

How can you help your child?

If you feel your child consistently demonstrates any of the signs listed above, speak with your pediatrician or primary care physician to seek out assistance from healthcare professionals. Therapy can assist to pinpoint the underlying process or processes in which your child has not developed appropriately and which are necessary for successful performance of and acquiring new motor skills. Physical Therapists can assist your child in reaching their maximum potential to function independently and to promote active participation in the home, school, and community. They promote independence and increase participation with age appropriate activities by facilitating motor development and function, improving strength and endurance, and enhance learning opportunities to ease physical challenges that lead to frustration. A physical therapist will also educate you and your family on strategies to aid in helping your child improve performance and reduce frustration with day to day activities.

Occupational Therapists can assist a child in participating with daily life activities or “occupations” related to children such as play, and motor development. They can facilitate the development of age appropriate skills through meaningful activities and play. They can focus on fine motor skills including handwriting and printing. Thinking skills can also be addressed to assist with motor planning which will help with improved coordination.

A Speech Therapist can assist with one on one sessions focusing on improving the planning, sequencing, and coordination of muscle movements for speech production. The speech therapist can use feedback from a number of senses, such as tactile “touch” cues and visual cues as well as auditory feedback to improve muscle coordination and sequencing for speech.

If you would like an in home evaluation to determine if your child would benefit from any of the above services, please do not hesitate to contact us and schedule an appointment at your convenience.

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